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Ovarian cryopreservation after laparoscopic ovariectomy using the Endo-GIA stapling device and LAPRO-clip absorbable ligating clip in a woman: a case report
© Roux et al; licensee BioMed Central Ltd. 2011
Received: 22 April 2010
Accepted: 3 February 2011
Published: 3 February 2011
Several options are available for preserving fertility before cytotoxic treatment, including ovarian tissue cryopreservation. Most reported surgical techniques include electrocoagulation. Our hypothesis is that avoidance of electrocoagulation may decrease ovarian cortex injury during cryopreservation procedures.
We report a laparoscopic technique of whole-ovary removal without coagulation using Endo-GIA forceps and clips. Laparoscopic ovariectomy was performed for cryopreservation in a 37-year-old Caucasian woman with breast cancer and for whom chemotherapy was planned. The procedure was completed quickly and without complication. This Endo-GIA procedure was of short duration with a short period of ischemia before freezing.
Laparoscopic ovariectomy using the Endo-GIA stapling device procedure without coagulation may diminish ovary injury before ovarian cryopreservation.
Several options are available for preserving fertility before cytotoxic treatment, namely embryo cryopreservation, oocyte cryopreservation and ovarian tissue cryopreservation. Embryo cryopreservation results in good pregnancy rates, but the patient needs to be of pubertal or postpubertal age, have a partner and be able to undergo a cycle of ovarian stimulation . Ovarian stimulation is not possible when chemotherapy cannot be delayed or when stimulation is contraindicated. Ovarian tissue transplantation after cryopreservation is an option despite being an experimental technique with few live births reported . Either a part of cortical tissue  or whole ovary can be removed.
This Endo-GIA procedure was of short duration with a short period of ischemia before freezing. Furthermore, it is known that the Endo-GIA stapling device requires significantly less time than electrocoagulation . However, some centers do not remove a whole ovary for ovarian tissue cryopreservation; instead, they remove only half to two-thirds of one macroscopically normal ovary's cortex. The Endo-GIA removal procedure cannot be used in these cases.
Laparoscopic ovariectomy using the Endo-GIA stapling device procedure without coagulation is an optional ovariectomy technique that should diminish ovary injury before ovarian cryopreservation.
Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review from the Editor-in-Chief of this journal.
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